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Dr Guy-André Pelouze

Hazards of the ‘Low-fat’ Dogma

According to the World Health Organisation (WHO), obesity worldwide has more than doubled since 1980. In 2014, over 1.9 billion adults (18 years and older) were overweight – 600 million of them were obese.

That means 39% of adults aged 18 years and over were overweight in 2014, and 13% were obese. Furthermore, 42 million children under the age of 5 were overweight or obese in 2013.

Those figures and statistics are extremely worrisome. They take the obesity issue to a whole new level: obesity is an epidemic. As such, it should be considered a global emergency for many reasons, including:

  1. Most of the world’s population lives in countries where being overweight or obese is a substantial killer.
  1. The cost of these illnesses will be “astronomical”, as stated by Marion Nestle, who chairs the Department of Nutrition and Food Studies at New York University.

But, as is elegantly put in the summary of the fact sheet on the WHO website, ‘obesity is preventable’. The WHO goes on to explain the fundamental cause of obesity. Far from being unexpected, the assumption is that there is an energy imbalance between calories consumed and calories expended. Globally, there has been:

  • an increased intake of energy-dense foods that are high in fat; and
  • an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation and increasing urbanisation.

 

Unfortunately, the answer to this global public health issue is not even close to helping patients. The WHO’s answer as to what causes the obesity epidemic is part of the reason why we inefficiently try to deal with it.

To me, it is very clear by now that the energy imbalance between calories consumed and calories expended is to blame. However, the concept of calories is most likely wrong and cannot explain obesity alone.

In this, the work of Dr Robert H Lustig (Professor of Paediatrics in the Division of Endocrinology; and Director of the Weight Assessment for Teen and Child Health Programme at University of California, San Francisco) is more than noteworthy.

But more importantly, WHO’s answer pointing towards fat as the main issue (‘increased intake of energy-dense foods that are high in fat’) needs to be reassessed. Evidence clearly shows that such foods are not solely responsible for the obesity epidemic. Fat alone cannot explain obesity.

Rising incidence of diabetes

According to the WHO, the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence among adults over 18 years of age rose from 4.7% in 1980 to 8.5% in 2014 and has been rising more rapidly in middle- and low-income countries.

Diabetes is a major cause of heart attacks, stroke, blindness, kidney failure and lower limb amputation. One death every six seconds can be attributed to Type 2 diabetes.

Worldwide, approximately 1 in 10 adults has Type 2 diabetes mellitus. A significant fraction of the population has some degree of insulin resistance – approximately 40% in the US. The projection the WHO makes is that diabetes will be the seventh leading cause of death in 2030.

The incidence of diabetes is expanding extremely quickly and is a legitimate cause of worry. This is particularly because – as the WHO fact sheet reminds us – diabetes can be prevented or delayed with a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use.

The WHO is actively promoting diabetes prevention and care management. There even is a World Diabetes Day. However, as surprising as it may seem, sugar is still not a definite target in the fight against diabetes.

Fat, sugar and prevention behaviour

With preventable diseases, patients can actually be part of the prevention behaviour. That is one of the most interesting aspects of nutrition as a field of study. Patients are in control of what food they purchase and consume. Provided they understand the consequences of their choices, they can be responsible. They need to understand the impact that the food they eat has on their health.

In previous papers and articles, we have shown that scientific evidence does not support the theory that was seen as the truth for so long. For ages, fat has been considered the cause of metabolic disease – but it obviously is not.

The fact that we have believed it for so long has led to room for concepts like that of Ancel Keys to grow and prosper. This destroyed perfectly good food habits that we used to have, leading to what we might now call the worst food epidemic ever known.

Those beliefs have driven us to take fat off our plates over time. That in itself is not the issue (although the body needs fat to work properly). But since fat and flavours are very closely related, fat-free or low-fat products were literally not edible. Neither were they satiable.

With close to no fat in our food, we had to find a solution; something to replace it in order to make food products palatable. And if that solution could be affordable, then the food industry would thrive.

Sugar was the answer everyone was looking for at the time. It replaced fat, made the food taste good and was inexpensive. It may even have been the easiest and cheapest solution at the time.

More importantly, it generated that strong positive reward in your brain – such a reaction in fact, that one can be addicted to sugar and crave it more and more.

Contrary to popular belief, fat does not make you fat; sugar does. The more sugar we ingest, the fatter we become. We then look for dietary solutions and end up consuming more low-fat, diet-food products. This adds to the problem by providing fewer fats and even more sugar to the body. All the sugar consumed stresses the pancreas; this, in turn, has an effect on insulin resistance.

The assumption that fat is unhealthy is therefore erroneous, as is the assumption that we consume too much of it. As a case in point, palm oil is a healthy source of lipids and vitamins, and is also free of trans fats. Yet, it has suffered a smear campaign over the last few years. As with many ‘low-fat’ products, we have found ‘palm oil-free’ products on shelves.

Fat in general, and palm oil in particular, is not – and never was – the culprit it was made out to be. Palm oil has a balanced composition that makes it one of the healthier options among oils and fats. Studies published over the last 10 years show precisely that we should not worry about palm oil, as it can be part of a balanced diet.

Sugar is not as easy to defend. Fructose – one of the dozens of forms of sugar – has always been present in fruit; but other kinds of sugar added to just about every food product have no particular metabolic benefit. Over-consumed, sugar does more harm than good. It promotes obesity and is responsible for diabetes, two epidemics that are among the leading causes of mortality.

Solutions at hand

Let me be straightforward: you should cut added sugars in order to reduce the amount consumed. But sugar is often hidden in food products; and since it has so many different names, it is difficult to identify. Low-fat products in particular, are riddled with hidden sugars.

We should move away from the low-fat dogma, and governments and regulators should absolutely support that shift. We should be looking to restore food habits we once had, where fat was considered healthy and sugar was not so frequently found in food. Those in charge of publishing dietary guidelines should recognise the scientific evidence supporting fat over sugar and take immediate action.

A healthy balance of fats should always be a key component of the diet. Palm oil is a prime example of this – it is good and healthy; and its balanced composition of saturated and unsaturated fat makes it also ideal for cooking.

Furthermore, it is very difficult to over-consume fat, as it is very satiating. Consuming fat in a low-carbohydrate diet also makes it easier for the body to access fat for energy.

Consumers are able to decide what they eat. However, they should be guided by the best available science. Moving away from added sugars and other carbohydrates, while adding more natural fats like palm oil, will rapidly improve health. It is time that regulators recognise, and endorse, this fact.

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Dr Guy-André Pelouze

Manger du gras signifie-t-il être plus gras ? Une explication du métabolisme Humain

Cela parait logique : manger du gras, signifie devenir plus gras. Mais ce n’est pas toujours le cas.

Cette question est très difficile à appréhender d’une manière générale, puisque ce principe, cette assertion est intuitive. Et comme toujours, ce que qui est intuitif semble toujours dominer à ce qui ne l’est pas autant.

Malheureusement, la biologie n’est pas là pour plaire. Elle nous enseigne que ce n’est pas le gras que nous mangeons qui se déposera dans nos artères. En effet, il n’y a pas de lien bien établi entre le cholestérol que nous mangeons, entre les graisses que nous ingérons et ce qui se dépose ou non dans nos artères. Pourquoi ?

Machine métabolique

C’est finalement assez simple à comprendre. Entre ce que nous mangeons et nos artères, il y a d’abord une énorme machine métabolique.

Le foie retransforme, reconfigure, réadapte tout ce que nous mangeons après la digestion par le tube digestif, de telle sorte que nos besoins soient remplis.
Cette machine métabolique fabrique des petites gouttelettes dans le sang pour transporter les graisses vers les tissus périphériques, afin de les utiliser, produire de l’énergie, créer des membranes, produire des hormones… Le foie régule tout cela.

Le foie en chef d’orchestre

Le deuxième point qu’il faut prendre en compte, c’est que le foie est parfaitement capable dans une situation d’excès de calories de transformer des sucres en graisses. Or, que mangeons-nous aujourd’hui en grande quantité ? Des amidons : du pain, des pâtes, du blé, du maïs, un certain nombre de céréales au petit déjeuner etc. Tout cela représente beaucoup plus que 50 %, parfois 60%,  voire 80% de sucres, de glucides. Ceci fait l’objet de discussions, dans le milieu diététique, qui insiste que le focus ne devrait pas être sur le gras, mais sur le sucre.

Et que fait le foie devant cette situation d’inondation ? Il transforme, tranquillement mais surement, ces glucides en lipides, ces petites gouttelettes qu’il envoie ensuite dans le tissu adipeux. Si bien que vous pouvez ne manger que très peu de gras et pourtant produire via le foie quantité de triglycérides, c’est-à-dire de graisses. C’est là que gît l’échec de tout ce qui est low-fat – c’est-à-dire allégé, sans graisse, sans huile de palme – parce qu’en réalité, par effet de substitution, nous sommes obligés de remplacer les lipides par des glucides.

Le low-fat n’a pas de goût ; le goût est transporté par le gras. Donc pour pallier le manque de goût, on rajoute des glucides, des sucres. Notre corps a besoin d’une absorption de gras que l’on trouve dans l’huile de palme (50% saturé et 50% non saturé), en remplacement des glucides et sucre qui sont mauvais pour la santé sont la réelle cause de calories. Attention : Ne faites pas confiance aux produits ‘sans huile de palme’ ou ‘sans gras’. Cela peut paraître attrayant, mais ne vous rendront pas en meilleure santé. C’est uniquement un tour des compagnies impliquées, sans aucun fondement.

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Dr Guy-André Pelouze

Why Fatty Foods Do Not Have to Mean ‘Getting Fat’: An Explanation of Human Metabolism

It sounds intuitive: eat food-containing fat, and you will get fat. And yet it simply is not always true. For many people, this is very difficult to grasp, because this principle, this assertion is intuitive.  And as is usually the case, the intuitive always seems to override the actual facts.

Unfortunately, biology is not there to be simplistic.  It teaches us that it is not the fat that we eat that will be deposited in our arteries.  Indeed, there is no clear established link between the cholesterol that we eat, between the fat that we ingest and what gets deposited or not in our arteries.  Why?

Metabolic machine

It is actually quite easy to understand.  In between what we eat and our arteries, there is a massive metabolic machine to begin with.

The liver reconverts, reconfigures, and readjusts everything we eat after it has been digested by the digestive tract, in such a way that our needs are met. This metabolic machine makes little droplets in the bloodstream to transport fat towards peripheral tissues, in order to use it, produce energy, create membranes, produce hormones…  The liver regulates all this.

The liver as conductor

The second point that needs to be taken into consideration is that the liver is capable of transforming sugar into fat in a situation of surplus calories.  Now, what do we eat in great quantity today?  Starch: bread, pasta, wheat, corn, a certain number of cereals for breakfast etc.  All this represents much more than 50%, sometimes 60%, or even 80% of sugar, of carbohydrate. This is being discussed more and more, in dietary circles that the focus should not be on fats, but rather on sugar.
What does the liver do in the face of this situation of flooding?  It converts, slowly but surely, this carbohydrate into lipid, these little droplets that it then sends into the adipose tissue.  So much so that you can eat very little fat and nonetheless produce masses of triglycerides, that is fat, through the liver.  This is where lies the failure of all that is low-fat – that is light, without fat, without palm oil – because in reality, by substitution effect, we are often compelled to replace the fat by carbohydrate.

Low-fat is tasteless; because taste is often carried by fat.  Thus, to compensate for the lack of taste, we add carbohydrate, sugar. The body needs the intake of balanced fats that you can find in palm oil (50% saturated fats and 50% unsaturated) and substituting it with carbohydrates and sugar is not healthy for the body. It is a mistake to want to replace fats by carbohydrates or sugars that are real source of calories. This should be a warning: do not trust the foods where you read ‘no palm oil’ or ‘no fat’. It may sound enticing, but will not make you healthier. It is simply spin from the companies involved, without any science.

 

 

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Dr Guy-André Pelouze

Myth and Fat: How One Inaccurate Hypothesis Mislead Public Health Policies for Generations

Dr Ancel Keys (Jan 26, 1904–Nov 20, 2004) was an American scientist who studied the influence of diet on health. He is responsible, almost more than any other individual, for the public health misconception around fats that exists today. Through published work that was vaunted across the world, Dr Keys has had a far-reaching impact on how we think about the role of fats.

When Dr Keys first published his theories, alleging that saturated fats were uniquely harmful, they were controversial. This controversy remains strong today as the debate on the roles of fat and sugar in relation to cardiovascular disease (CVD) associated with atheroma (the fatty material that forms plaques in arteries) goes on.

This article reflects upon two main subjects: understanding the complexity of chronic diseases as the antithesis of acute infectious diseases; and the principle of falsifiability applied to atheroma theories and the practical consequences this entails.

After World War II, the work of Dr Keys played a fundamental role in the debate around fats. How?

Because it claimed to demonstrate a link between saturated fats consumption and atheroma: “Many factors are probably involved in the atherosclerotic development and in the clinical appearance of coronary heart disease, but there is no longer any doubt that one central item is the concentration, over time, of cholesterol and related lipids and lipoproteins in the blood serum. No other etiological (sic) influence of comparable importance is as yet identified.” ( A. Keys, American Journal of Public Health, Nov 1953, vol 43, 1399-1407.)

Today, in reality, scientists see tobacco, diabetes and hypertension to be much more powerful risk factors. We condemn researchers who, for over 40 years, have not been keen to verify the data and the conclusions it suggested.

Epidemiology in modern history

Epidemiologic observations have drawn the attention of scientists for a long time on the link between dietary change and cardiovascular diseases. Examples of populations with low CVD prevalence or populations where CVD are the first cause of mortality have led epidemiologists to do research on food.

This is what we called the DietHeart Hypothesis. But it is so incredibly complex that even till today, we have yet to come up with a definitive answer. Simple hypotheses (i.e. single-factor cause) and invalid experimental models have produced abundant literature, of which little is actually helpful.

We can, however, wonder about the recent dietary changes brought by the recent industrial transition. In the West, those changes can be qualified with three factors:

  • Abundance of calories
  • Abundance of carbohydrates
  • Abundance of processed foods

Further to these, we should not forget about calorie expenditure. In industrialised countries, we have shifted to a sedentary lifestyle (at work, in public transportation or for personal activities).

Dr Keys supported his hypothesis with charisma. How is that possible? He and his team set out to study the dietary characteristics and lifestyles of different populations worldwide and compare the prevalence of coronary diseases. It was a rather large study at the time and needed significant funding.

This study addressed the issue of the heart attack epidemic that was hitting the United States and other developed countries at the time. He quickly focused on diet-related risk factors, mostly because they were easier to measure, particularly through blood levels.

Among macronutrients, Dr Keys had already explored fat and the indirect measure of blood lipids via blood cholesterol.

The study would be published in a book in 1980 ( Seven Countries. A multivariate analysis of death and coronary heart disease).

In the meantime, Dr Keys got more famous, was interviewed often, and in January 1961, was on the cover of Time Magazine.

Dr Keys described a link in the studied cohorts between the percentage of saturated fats in the diet and the death rate by coronary events. The correlation was dependent on the number of countries studied, but it was significant in the cohorts he chose.

As there was a correlation between total blood cholesterol and the same events, and as Dr Keys highlighted that saturated fats (especially palmitic acid as it is the most common) increased blood cholesterol, a conclusion appeared.

He stated that saturated fats, including palmitic acid, were linked to coronary atheroma. Others have then bridged the gap, saying they cause coronary diseases.

Obviously, all of this was not true. Inaccuracies and biases made his observations invalid.

Even Dr Keys ended up publishing more balanced conclusions than others: “Our 10 year finding, and concordance with other studies, make it clear that the big three risk factors for coronary heart disease now established are age, blood pressure, and serum cholesterol. The findings about cigarette smoking as a risk factor indicate that here, too, relationships are not as simple as first supposed.” ( Seven Countries, page 341).

He later became an advocate of the Mediterranean diet and kept studying it for a while. In 1975, he published How to Eat Well and Stay Well the Mediterranean Way.

Consequences still felt today

Dietary guidelines from experts and governments have been largely based on Dr Keys’ work.

To lower our intake in cholesterol and saturated fats, populations have massively consumed food products in which fats have been replaced with carbohydrates, and saturated fats with vegetable oils rich in omega-6.

This did not change the prevalence of atheroma-related diseases. New research even shows these changes may be linked to the obesity epidemic and type 2 diabetes.

Palm oil for one, which has a good balance between saturated and unsaturated fats, constitutes a healthy alternative – but it has been unjustly maligned for containing saturated fats.

There have been economic consequences too. This is linked to the food industry’s ability to quickly find a new market opportunity with low-fat food products. It has, as always, been shown to be very innovative in that regard.

Its lobby was powerful and the “low-fat” concept developed globally even though it is not possible as of yet to show it has any positive impact of cardiovascular health.

In the 40 years between Dr Keys’ work and the shadow cast upon it, many scientific articles have been published to try and explain the anomalies observed in real populations.

None ever questioned what had become a dogma. The different paradoxes, including the famous French Paradox, have only started to shake the foundation of his hypothesis.

Who bears the responsibility?

Surely, Dr Keys cannot be held responsible for how his data was used.

But his vision clearly influenced medicine for generations and overstated the importance of saturated fats and cholesterol in cardiovascular risk.

A summary of the Seven Countries Study on the University of Minnesota, US (where the study was coordinated), website, had this to say: “The main implications of the Seven Countries Study are that the mass burden and epidemic of atherosclerotic diseases has cultural origins, is preventable, can change rapidly, and is strongly influenced by the fatty composition of the habitual diet.

“The study implies the universal susceptibility of humans to CVD, but that the frequency of susceptible phenotypes is greatly reduced in favourable environments. It suggests there may be other and important protective elements in the diet and lifestyles of Crete and Japan.”

The only concession made to Dr Keys’ theories is the confirmation of a strong influence of the composition of lipids in the diet, but the words “saturated fats” are no longer used.

The Journal of the American College of Cardiology recently reminded physicians:“Atherosclerosis is a multifactorial disease and requires a multifactorial approach with smoking cessation, dietary modification and weight management, regular physical activity, attention to psychosocial risk factors, and pharmacological therapy of lipid and nonlipid risk factors.

“Comprehensive risk factor control is associated with improved prognosis, and our challenge is to develop care models that will allow us to achieve such control.”

We need to keep in mind that tobacco, type 2 diabetes and hypertension are, in that order, more powerful atheroma risk factors than LDL particles. There is no interest in dietary cholesterol in preventing CVD.

Saturated fats, like monounsaturated fats, and like carbohydrates, increase the amount of LDL particles when in calorie excess and promotes atheroma if other risk factors are present, and if phenotype is susceptible.

This is the reason why we cannot predict among high-LDL patients those who will have a cardiovascular, cerebral or peripheral event, other than watching the three aforementioned powerful risk factors, or having proper atheroma plaques exams.

In summary, Dr Keys was wrong, and his mistake has been compounded over the decades. It is time now to end the crusade against saturated fats.

The Star Malaysia 24 Apr 2016

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Dr Guy-André Pelouze The Oil Palm

Manger du gras signifie-t-il être plus gras ?

Cette question est très difficile à appréhender d’une manière générale, puisque ce principe, cette assertion est intuitive. Et comme toujours, ce que qui est intuitif semble toujours dominer à ce qui ne l’est pas autant.

Malheureusement, la biologie n’est pas là pour plaire. Elle nous enseigne que ce n’est pas le gras que nous mangeons qui se déposera dans nos artères. En effet, il n’y a pas de lien bien établi entre le cholestérol que nous mangeons, entre les graisses que nous ingérons et ce qui se dépose ou non dans nos artères. Pourquoi ?

Machine métabolique

C’est finalement assez simple à comprendre. Entre ce que nous mangeons et nos artères, il y a d’abord une énorme machine métabolique. Je le dis souvent : nous ne sommes ni un réfrigérateur ni un espace de stockage ; ce que nous mangeons est profondément transformé par le foie.

Le foie retransforme, reconfigure, réadapte tout ce que nous mangeons après la digestion par le tube digestif, de telle sorte que nos besoins soient remplis. Notre foie est capable de presque tout transformer. Si ce n’était pas le cas, nous ne serions pas là car nous n’aurions pas survécu.
Cette machine métabolique fabrique des petites gouttelettes dans le sang pour transporter les graisses vers les tissus périphériques, afin de les utiliser, produire de l’énergie, créer des membranes, produire des hormones… Le foie régule tout cela.

Le foie en chef d’orchestre

Ainsi on comprend que la quantité de ce que l’on mange va être déterminante. Il est évident que si l’on mange beaucoup trop, le foie sera obligé de trouver comment utiliser tous ces nutriments dont il n’a que faire, parce qu’on n’en dépense pas. C’est un des grands sujets aujourd’hui : la sédentarité et l’alimentation bon marché ont précipité l’être humain dans une balance calorique positive.

Le deuxième point qu’il faut prendre en compte, c’est que le foie est parfaitement capable dans une situation d’excès de calories de transformer des sucres en graisses. Or, que mangeons-nous aujourd’hui en grande quantité ? Des amidons : du pain, des pâtes, du blé, du maïs, un certain nombre de céréales au petit déjeuner etc. Tout cela représente beaucoup plus que 50 %, parfois 60, voire 80% de sucres, de glucides.
Ces glucides en excès sont souvent d’absorption très rapide. Et que fait le foie devant cette situation d’inondation ? Il transforme, tranquillement mais surement, ces glucides en lipides, ces petites gouttelettes qu’il envoie ensuite dans le tissu adipeux. Si bien que vous pouvez ne manger que très peu de gras et pourtant produire via le foie quantité de triglycérides, c’est-à-dire de graisses. C’est là que gît l’échec de tout ce qui est low-fat – c’est-à-dire allégé, sans graisse, sans huile de palme – parce qu’en réalité, par effet de substitution, nous sommes obligés de remplacer les lipides par des glucides. Le low-fat n’a pas de gout ; le gout est transporté par le gras. Donc pour pallier le manque de goût, on rajoute des glucides, des sucres.

Il n’y a donc aucun rapport entre ce que vous mangez et ce qu’il va se passer dans vos artères. L’élément essentiel est qu’il faut à tout prix conserver son caractère le moins transformé, le plus naturel possible à ce que vous mangez. En clair, il faut privilégier des aliments et non des produits alimentaires, qui vont aggraver l’inondation de calories et de glucides dans votre organisme.

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Authors Dr Guy-André Pelouze

Fats and Mortality: Beginning of the End of a Myth

The conventional wisdom that saturated fats are problematic for human nutrition is simply not credible any more, in the face of increasing scientific evidence. The latest evidence comes from De Souza et al, who have published in the British Medical Journal (http://www.bmj.com/content/351/bmj.h3978) looking into saturated fat consumption. I will examine the scientific details in this blogpost – but the important headline is that we, as medical professionals, media, society, need to challenge the previously assumed link between saturated fats and CVD. The evidence now shows that the old advice was wrong.

Palm oil is one saturated fat that has suffered from this misperception: my hope is that the more evidence emerges, the more difficult it will be for anti-palm oil activists to persist with their erroneous negative claims.

Saturated fat consumption, scientific interest and political issues

Fat consumption has been scrutinised by researchers and government agencies since the aftermath of World War 2. This is mainly the consequence of the lipid heart hypothesis formulated by the scientist Ancel Keys, in the 1950s, which was never confirmed but has passed into dietary guidance ever since. This study suffered all the bias of retrospective or prospective non-interventional epidemiological studies about diet and CVD. Particular weaknesses include –

  • Very poor quality of diet analysis and questionnaires
  • No control group and a lot of confounding parameters
  • Weak correlations and very low absolute risk differences
  • Wide range of metabolic responses among individuals to intake of carbs / lipids / proteins
  • Ignorance of the type of fat and especially the amount of industrially produced trans fats
  • Selection of countries and/ or avoidance of those with high intake of saturated fats and low CVD rates like France or Spain.

To illustrate this, let me review the selection process of the studies as shown in Figure 1 of the paper (http://www.bmj.com/content/351/bmj.h3978). THE BMJ paper finds that os much of the literature on saturated fats following Ancel Keys was not of sufficient scientific quality. From 20,413 studies in the database, only 41 were selected (because of lack of information, low quality, and other insufficiencies). For instance, from the 445 studies resulting of a process of eligibility based on the full text, 372 were excluded because:

  • They did not assess saturated fat exposure
  • They did not measure outcomes of interest
  • They duplicate data from previous publications
  • They did not present a measure of associations
  • They have an inappropriate study design.

There is more, the GRADE (http://www.gradeworkinggroup.org/index.htm) evidence profile of quality is very low for all the comparisons done in the selected studies in the past around saturated fats, as found yb the BMJ (http://www.bmj.com/content/bmj/suppl/2015/08/11/bmj.h3978.DC1/sour025275.ww5_default.pdf).

What are the findings?

Once more, I have to insist on a critical point in human observational studies about diet: mortality is crucial. Without any effect on mortality, observational studies should be taken with extreme precautions for further conclusions. Figure 2, which is displayed below, illustrates very precisely how saturated fat are neutral on different risks and the great heterogeneity of studies on CHD and saturated fats.

 

Untitled

Untitled2

Recently the number of papers by nutrition specialists who doubt or challenge results of studies about saturated fats and CVD has increased because the statistical reality as assessed by meta-analysis or recalculating old data is indeed against any detrimental effect of saturated fats on cardiovascular health.

Atheroma and CVD are complex issues, which are not caused by fat (or cholesterol) in your plate, and therefore not caused by palm oil.

Without a doubt, we are near the end of a myth. The only surprise is the slowness of the process i.e. the extraordinary conservatism of the scientific community about the diet heart hypothesis. No doubt that economic interests (the low-fat industry, the sugar industry and at large the agro-food industry) and the traditional reluctance to change of highly centralised bureaucracy are key explanations for exceptional lasting of this myth. But enough is enough because this advice is not neutral and even deleterious to populations following it and consequently do not engage in actual and efficient prevention of CVD.

 

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Dr Guy-André Pelouze The Oil Palm

L’Huile de Palme est une excellente huile pour cuisiner : résistante à la chaleur et saine

Dans un article publié récemment, le journaliste du UK Daily Telegraph, Robert Mendick explique comment les huiles végétales peuvent devenir toxique lorsqu’elles sont chauffées, car elles libèrent des “produits chimiques cancérigènes toxiques”. Dans cet article, cinq graisses différentes sont comparées: deux graisses saturées (huile de noix de coco et le beurre) et trois végétales, des huiles hautement insaturées (huile d’olive extra vierge, de maïs et d’huile de tournesol).

Il est vrai que toutes les graisses ne sont pas identiques. Il est également vrai qu’aucun gras n’est parfait. Ce qui est important de comprendre est que certaines graisses, animale ou végétale, sont bonnes lorsqu’ elles sont utilisées à froid, comme vinaigrettes ou marinades, par exemple; tandis que d’autres sont mieux adaptées pour la cuisson, faire sauter ou frire. La chaleur peut être rude sur certaines graisses, en particulier les huiles végétales, comme l’a indiqué l’article du Telegraph.

L’huile végétale ne signifie pas gras insaturé

Le journaliste a comparé des huiles végétales souvent considérées comme saines (maïs, tournesol) à d’autres matières grasses riches en acides gras saturés, tels que l’huile de noix de coco ou du beurre. Les huiles et les graisses saturées sont plus stables lorsque la chaleur est appliquée. Par conséquent, comme le montre l’étude citée dans cet article, elles sont une alternative plus saine en ce qui concerne la cuisson. Donc, l’huile de noix de coco est idéale, car elle contient environ 85% d’acides gras saturés, tout comme le beurre avec 65% d’acides gras saturés.

Ce qui est étrange, cependant, c’est que l’huile de palme ne soit pas mentionné. Avec une composition équilibrée (50% saturés et 50% insaturés), l’huile de palme est parfaite pour la cuisson, y compris pour frire, car elle est très résistante à la chaleur. Elle ne se décompose pas lorsque utilisée pour la friture. Elle est aussi naturellement sans gras trans et sans cholestérol.

Une alternative saine et équilibrée

Un article vraiment précis aurait établi l’huile de palme comme l’une des meilleures alternatives aux huiles de mais et tournesol pour la cuisson. L’excellente résistance de l’huile de palme à la chaleur et sa composition équilibrée en fait une des options disponibles les plus saine.

L’éducation sur l’alimentation et la cuisine est essentielle si les Européens veulent améliorer leur régime alimentaire et leur santé. L’utilisation de l’huile de palme comme une huile de cuisson, à la place des huiles insaturées potentiellement dangereuses (tournesol, maïs) est un excellent exemple de cela.

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Authors Dr Guy-André Pelouze

Palm Oil is an Excellent Cooking Oil: Heat-Resistant and Healthy

In an article published recently, The UK Daily Telegraph journalist Robert Mendick wrote about how vegetable oils become toxic when heated, because they release “toxic cancer-causing chemicals”. In this article, five different fats are compared: two saturated fats (coconut oil and butter) and three vegetable, highly-unsaturated oils (extra virgin olive oil, corn and sunflower oil).

It is indeed true that not all fats are equal. It is also true that no fat is perfect. What is important to understand is that some fats, whether animal fat or vegetable oil, are good when used cold, in salad dressings or marinades for instance; while others are better suited for cooking, sautéing or frying. Heat can be harsh on some fats, especially vegetable oils, as was stated on The Telegraph article.

 

Vegetable oil doesn’t mean unsaturated fat

The journalist compared vegetable oils often considered healthy (corn, sunflower) to other fats rich in saturated fatty acids, such as coconut oil or butter. Saturated oils and fats are more stable when heat is applied. Therefore, as shown by the study quoted in the article, they are a healthier alternative when it comes to cooking. So coconut oil is ideal, as it contains roughly 85% of saturated fatty acids, so is butter with 65% saturated fatty acids.

What is odd, though, is that palm oil is not mentioned. With a balanced composition (50% saturated and 50% unsaturated), palm oil is perfect for cooking, even frying, as it is very heat-resistant. It doesn’t break down or mutate when used for frying. It is also naturally trans-fat free and cholesterol free.

 

Healthy, balanced alternative

A truly accurate article would have established palm oil as one of the best alternatives to corn or sunflower oil for cooking. Palm oil’s excellent heat resistance and balanced composition make it one of the healthier options available.

Education about food and cooking is essential if Europeans are to improve their diets and overall health outcomes. Using palm oil as a cooking oil, in place of the potentially-hazardous unsaturated oils (sunflower, corn) is a prime example of this.

 

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Dr Guy-André Pelouze The Oil Palm

La campagne contre l’huile de palme sans aucun fondement scientifique

En Novembre 2012, l’huile de palme est vraiment entrée dans le paysage médiatique français à l’occasion des discussions parlementaires au sujet de ce qui a été surnommé à l’époque l’amendement Nutella. Un prodigieux nombre d’articles a été publié à cette occasion. Et de l’omniprésence dans les médias, l’huile de palme est devenue un des grands sujets du débat public.

Quel terrain fertile pour une campagne de dénigrement ! On l’a accusée de tout et particulièrement d’être mauvaise pour la santé ; et au creux de l’actualité, la question sanitaire a pris des tours de préoccupation nationale.

Pourtant la science ne permet pas de donner raison à ces craintes. Pour l’huile de palme comme pour d’autres sujets, à défaut d’avoir promu les bonnes informations, l’opinion publique s’est surtout démarquée par sa tendance à l’exagération. D’ailleurs les affiches que nous avons pu voir dernièrement à propos du monstre du Loch Ness ou du Titanic ne sont finalement pas très loin de la vérité.

Nous avons à plusieurs reprises tenté de montrer qu’il n’y avait pas réellement motif à une telle activité médiatique : en Novembre 2013 dans un premier temps, puis en juin 2014, nous avons tenus deux colloques à Paris et à Bruxelles, avec le concours d’experts renommés. Ensemble, nous avons précisé l’état de la science et de nombreuses études menées au cours de ces dernières années ont permis d’avancer, sans erreur possible, que les graisses saturées en général et l’huile de palme en particulier ne sont évidemment pas dangereuses pour la santé.

Aujourd’hui, comme c’était également possible de le dire alors, l’huile de palme n’est pas un sujet d’inquiétude sur le plan scientifique. Force est de constater que l’opinion publique a fait fausse route.

D’ailleurs on ne s’y est pas trompé. Dix-huit mois environ après le pic d’intérêt, ce débat s’est étouffé de lui-même. Des premières grandes guerres sanitaires et idéologiques, on a vite pu se rendre compte qu’il n’y avait pas de fond. Et des sujets plus sérieux comme l’utilisation toujours actuelle des graisses trans ou l’inquiétante consommation de sucre ont pu faire surface.

Après quelques mois seulement donc, tout ceci s’est effondré. Beaucoup de bruit pour rien.

 

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Authors Dr Guy-André Pelouze

The Anti-Palm Oil Campaign with No Basis in Science

In November 2012, palm oil definitively entered the French media landscape during parliamentary discussions on what was at the time christened as the so-called ‘Nutella Amendment’ or ‘Nutella Tax’. A prodigious number of articles were published at that time. And, stemming from its omnipresence in the media, palm oil then became a major topic of public debate.

What fertile ground for a smear campaign! Palm oil was accused of everything – and especially of being bad for health – and in the news media, this health issue became a national concern.

Yet, science does not provide any reason for these fears. For palm oil as for other subjects, the failure to promote the correct information meant that public opinion was mainly distinguished by its tendency to exaggerate. The advertising posters that we have seen recently in France about palm oil being linked to the Loch Ness monster or the Titanic are ultimately not very far from the truth of the scare campaign.

We have repeatedly tried to show that there was no real reason for such media activity: in November 2013 initially, and then in June 2014, we held two conferences in Paris and Brussels with renowned experts. Together, we clarified the state of the scientific evidence, and the many studies over the years have proved, unmistakably, that saturated fats in general and especially palm oil are undoubtedly not hazardous to health.

Today, just as it was possible to say in the past, palm oil is not a concern from a scientific point of view. It is clear that public opinion is on the wrong track.

However, we were not wrong. Eighteen months after the peak of interest, the debate is folding in on itself.

Since the first major wars over ideological health issues, people quickly realised that it didn’t have any basis in science. More serious topics such as the enduring use of trans fats or the worrying levels of sugar consumption could surface.

After only a few months the rationale of the anti-palm oil campaign fell apart. A lot of noise for nothing.